Although the Social Security Administration manages the federal disability programs, it rarely decides whether to approve or deny initial applications for SSDI or SSI.
Instead, state agencies called Disability Determination Services (DDS) review your adult function report and medical evidence to decide whether you qualify for benefits at the first two levels of the disability appeal process: the initial and request for reconsideration stages.
This article explains the role that Disability Determination Services has in your case.
If you have more questions about how to win the appeal a disability denial or if you want to hire one of Virginia’s best Social Security disability attorneys, complete this form or call (804) 251-1620 or (757) 810-5614.
DDS is part of the Virginia Department for Aging and Rehabilitation. It decides whether to allow or deny initial claims for Social Security disability benefits and reconsideration requests after reviewing the medical, educational, and vocational evidence.
It also reviews and adjudicates Medicare appeals.
Your state likely has a similar setup. All DDS offices nationwide must follow specific federal laws and regulations.
The United States Code – 42 USC Section 421 – gives states the power to decide if you are under a disability, the day such disability began, and whether your disability has ended.
To use this power, a State must tell the Commissioner of Social Security in writing that it wants to make such disability determinations.
Once notified, the Commissioner of Social Security will “promulgate regulations specifying, in such detail as the Commissioner deems appropriate, performance standards and administrative requirements and procedures to be followed in performing the disability determination function” to “assure effective and uniform administration of the disability insurance program throughout the United States.” For example, these regulations may specify the physical location of the State agency’s staff, performance criteria, and requirements for submitting reports and data.
Yes.
Despite delegating this power and adopting DDS’s decisions at the initial and reconsideration stages, the Commissioner of Social Security retains the power to review disability determinations by state agencies. Indeed, anyone displeased with a DDS determination may request an administrative law judge (ALJ) hearing with the SSA.
The federal government advances or reimburses Disability Determination Services from the Social Security Trust Funds.
After receiving your claim file from the local SSA field office, DDS will assign your case to a disability examiner (DE). This person is not a medical doctor.
The DDS disability examiner’s responsibilities include the following:
DDS claims examiners must evaluate your application according to the Program Operations Manual System (POMS).
No.
The DDS claim examiner assigned to your case does not have the qualifications to determine if you have a severe medical impairment or how your impairments affect you. Indeed, Social Security’s regulations do not allow disability examiners to make medical determinations in most cases.
Instead, the DDS disability examiner should rely on the findings of the medical consultants.
Usually, the DDS medical consultant receives your claim after the disability examiner has obtained your medical records, talked with you by phone about your medical treatment and activities, and reviewed your work history.
The medical consultant will not examine you in person. They will probably not even call you.
Generally, the medical consultant has these responsibilities regardless of the types of impairments alleged:
Probably not.
Although the DDS medical consultant must be a licensed medical doctor, osteopathic doctor, or psychologist with a Ph.D., it is unlikely that you will have received treatment with DDS’s medical consultant assigned to your case. Indeed, many DDS doctors are retired physicians.
DDS must notify you of its decision in writing.
If the DDS medical consultant finds you disabled and the claims examiner finds you meet the nonmedical requirements for disability, then both individuals will sign a determination form.
DDS sends the form to your local SSA field office so they can contact you to process benefits, including disability backpay.
If DDS denies your application, you should receive a Form SSA-831 Disability Determination and Transmittal. This paper will help you determine the reason for the denial.
No.
If you request reconsideration, a different DDS disability examiner and a new medical consultant will review your evidence.
However, the data shows that you will likely receive the same result.
The next step is to request a hearing before an ALJ, separate from DDS.
I recommend staying involved in your Social Security case, even if you have hired an attorney.
If you have concerns about what DDS is doing, consider these steps:
My view is that many DDS decisions are cold and mechanical. DDS claims examiners seem unwilling to look beyond the medical reports or give much weight to your reports of symptoms as found in the paperwork.
For example, I see claimants have much more success with disability claims at the ALJ level compared to the Disability Determination Services level when:
Therefore, you should expect to need the Social Security Administration to review the decisions from Disability Determination Services.
Below is the contact information for DDS offices in Virginia:
8004 Franklin Farms Dr.
Richmond, VA 23229-5019
Phone: (804) 662-7625
Toll Free: (800) 552-5019
Fax: (804) 662-9041 or (804) 662-7275
9960 Mayland Dr., Suite 200
Richmond, VA 23233
Phone: (804) 367-4700
Toll Free: (800) 523-5007
Fax: (804) 527-4523
5850 Lake Herbert Dr., Suite 200
Norfolk, VA 23502
Phone: (757) 466-4300
Toll Free: (800) 379-4403
Fax: (757) 455-3829
11150 Fairfax Blvd., Suite 200
Fairfax, VA 22030-5066
Phone: (703) 934-7400
Toll Free: (800) 379-9548
Fax: (703) 934-7410
612 S. Jefferson Street, Suite 300
Roanoke, VA 24011
Phone: (540) 857-7748
Toll Free: (800) 627-1288
Fax: (540) 857-7707
111 Franklin Road, S.E., Suite 250
Roanoke, VA 24011
Phone: (540) 512-1880
Toll Free: (877) 892-6871
Fax: (540) 512-1990
You can also contact your local Social Security field office to learn the status of your claim.
You may feel discouraged by the time it takes for DDS to decide your case or denials at the initial or reconsideration level.
But do not give up.
We can help.
Contact us today.